Vertebral Body Stapling versus Bracing for Patients with High-Risk Moderate Idiopathic Scoliosis.

Purpose. We report a comparison study of vertebral body stapling (VBS) versus a matched bracing cohort for immature patients with moderate (25 to 44 degrees) idiopathic scoliosis (IS). Methods. 42 of 49 consecutive patients (86%) with IS were treated with VBS and followed for a minimum of 2 years. They were compared to 121 braced patients meeting identical inclusion criteria. 52 patients (66 curves) were matched according to age at start of treatment (10.6 years versus 11.1 years, resp. [P = 0.07]) and gender. Results. For thoracic curves 25-34 degrees, VBS had a success rate (defined as curve progression <10 degrees) of 81% versus 61% for bracing (P = 0.16). In thoracic curves 35-44 degrees, VBS and bracing both had a poor success rate. For lumbar curves, success rates were similar in both groups for curves measuring 25-34 degrees. Conclusion. In this comparison of two cohorts of patients with high-risk (Risser 0-1) moderate IS (25-44 degrees), in smaller thoracic curves (25-34 degrees) VBS provided better results as a clinical trend as compared to bracing. VBS was found not to be effective for thoracic curves >35 degrees. For lumbar curves measuring 25-34 degrees, results appear to be similar for both VBS and bracing, at 80% success.